Cerebral venous thrombosis occurring in puerperium is about 10 to 12 times more frequent in India than in Western countries. A clinical study of 135 patients with cerebrovascular accidents in early puerperium is reported. Cortical vein thrombosis is common and arterial thrombosis rare (6/135). The illness usually occurs within the first two weeks, after normal delivery at full term, in a multiparous woman, with multi-focal seizures, stupor or coma, regressing focal signs or at times as pseudotumour cerebri. Deep leg vein thrombosis and pelvic sepsis are rare. Mortality has been high reaching 28 to 33 percent in both Indian and Western countries. With the use of anticoagulants in some selected patients and earlier; energetic, supportive and symptomatic measures in others the mortality could be reduced to less than 20 percent. The quality of survival is good since those who survive have only minimal physical disability.

BackgroundWorkers laboring in steel industries in tropical settings with high ambient temperatures are subjected to thermally stressful environments that can create well-known risks of heat-related illnesses and limit workers’ productivity.MethodsA cross-sectional study undertaken in a steel industry in a city nicknamed “Steel City” in Southern India assessed thermal stress by wet bulb globe temperature (WBGT) and level of dehydration from urine color and urine specific gravity. A structured questionnaire captured self-reported heat-related health symptoms of workers.ResultsSome 90% WBGT measurements were higher than recommended threshold limit values (27.2–41.7°C) for heavy and moderate workloads and radiational heat from processes were very high in blooming-mill/coke-oven (67.6°C globe temperature). Widespread heat-related health concerns were prevalent among workers, including excessive sweating, fatigue, and tiredness reported by 50% workers. Productivity loss was significantly reported high in workers with direct heat exposures compared to those with indirect heat exposures (χ2 = 26.1258, degrees of freedom = 1, p < 0.001). Change in urine color was 7.4 times higher among workers exposed to WBGTs above threshold limit values (TLVs).ConclusionPreliminary evidence shows that high heat exposures and heavy workload adversely affect the workers’ health and reduce their work capacities. Health and productivity risks in developing tropical country work settings can be further aggravated by the predicted temperature rise due to climate change, without appropriate interventions. Apart from industries enhancing welfare facilities and designing control interventions, further physiological studies with a seasonal approach and interventional studies are needed to strengthen evidence for developing comprehensive policies to protect workers employed in high heat industries.

SUMMARY Mandurai City is a composite of many villages with a total population not exceeding one million. Undoubtedly more than 95% of the hospital patients come from the rural areas. Our Government Hospital is the largest and reflects the medical assistance provided for people of average and low income.In our experience, 15% of cerebrovascular strokes occur in those below 40 years of age. Meningovascular neurosyphilis in men (10-15%) and puerperal cerebral venous thrombosis in women (20%) were the two commonly proved causes. Haemorrhagic stroke was uncommon. Embolic strokes from rheumatic heart disease formed 10%. In over 50%, the cause of stroke was not clear. Among 150 patients with neurosyphilis, mostly men, 25 had cerebral arterial thrombosis with stroke syndrome. This study reports on 138 patients with cerebral venous thrombosis and 7 patients with arterial thrombosis in puerperium. Mortality was 20% and quality of survival was good. The incidence, clinical picture, and diagnostic investigations are discussed with a review of literature. Stroke Vol 15, No 4, 1984 CEREBROVASCULAR DISEASE (CVD) occurs less commonly in the younger than 40 years age group. The incidence has been reported from Europe and Japan as varying between 17.4% and 33%.7 13 -l7 Indian reports 3 -8 ' 9 22 estimate the incidence as between 15 and 30% of strokes in all ages. It has been pointed out that the low life expectancy in India (52 years) biases the Indian sample. 9Over the past ten years in our teaching hospital (1800 in-patients), 300-350 patients were referred with vascular stroke each year and 15% of them were below the age of 40 years. Neurosyphilis in men and puerperal cerebral venous or arterial thrombosis in women were the commonly proved causes and accounted for 25% of stroke cases in the young. The causative factors in 40 patients in one year (1982) were as follows: puerperal venous thrombosis (CVT), 8 patients, neurosyphilis 5, rheumatic mitral stenosis with atrial fibrillation 5, and other causes in 22 patients including isolated examples of haemorrhagic strokes (due to aneurysm, A.V.M., malignant hypertension, coarctation of aorta, bacterial endocarditis, leukemia) and ischaemic strokes (due to aorto-arteritis, tuberculous meningitis, lupus erythematosis, fibromuscular dysplasia of cervical carotid artery). With increasing use of echocardiography, more cases of cardiac sources of embolism including mitral valve prolapse will be detected. Nevertheless, in over 50% of cases, the cause of stroke in the young is undetected. Higher incidence of haemorrhagic stroke has been reported in India from Kerala, West Bengal, and Chandigarh. However, in most centres, the incidence of haemorrhagic strokes in the young is around 13%. We are

Maternal mental health research is a public health priority due to its impact on both maternal and child health. Despite the growing number of empirical studies in this area, particularly from developing countries, there is a paucity of synthetic review articles. Therefore, attempting to synthesize the existing literature in this area seems relevant to appraise the readers of the field's progress and to infer directions for future research. The present review aims to provide an overview of the literature on maternal mental health and its association with birth outcomes and child behavior. Specifically, the literature on mental health during pregnancy and in the postpartum period and its influence on birth outcomes and child behavior have been reviewed. Further, a conceptual and methodological evaluation of the existing literature has been provided to identify gaps in the literature and to suggest directions for future research.

Medical research, from clinical trials to novel research on stored samples, is growing rapidly in India. Ethical regulations largely reflect standard international guidelines and the norms of "good clinical practice". Through in-depth interviews, this study aimed to explore the perceptions, motivations and concerns of the public with respect to participation in clinical trials and biobanking-related research. It was found that the expectation of therapeutic benefit reflects "therapeutic misconception" and this, along with a poor understanding of research, leads to favourable participation in clinical trials. A relatively low level of awareness and knowledge of health matters and research (health literacy), along with the differences in the power of the doctor and the participant, lead to an unquestioning trust in the physician or the institution conducting the research. "Informed consent" is thought to protect the interests of the researcher and the institution rather than the participants' rights. Biobanking research was very new to the participants and relatively unknown. Thus, it has not yet filtered into the public consciousness. As a result, the perceptions of the general public do not appear to be sufficiently evolved.